Smallpox was officially declared to have been eradicated worldwide in December 1979.

But few likely now that we have had rabies vaccines since 1885, a flu vaccine since 1945, or that the last case of wild polio in the United States was in 1979.

“It is hard to fully appreciate how vaccines have revolutionized modern medicine. The long schedule of vaccines may seem like a hassle, and rumors about harmful effects unnerve parents. But, the fact is, vaccines have helped save millions and millions of lives. Just a few generations ago, people lived under the constant threat of deadly infectious diseases, like smallpox, polio, and hepatitis.

Let’s look at the greatest infectious scourges of the past 1,000 years and how vaccines have mitigated or even eradicated the danger.”

Public Health Understanding Vaccines

From historical safety concerns, like the Cutter Incident in 1955 or the withdrawal of the first rotavirus vaccine in 1999, to improvements in vaccine safety and the control, elimination, and eradication of vaccine-preventable diseases, understanding the history of vaccines can help you get educated and understand that vaccines work and that they are safe and necessary.

Early History of Vaccination

In the early history of vaccination we had the the smallpox vaccine and the beginning of the pre-vaccine era – the first vaccines.

George Washington mandated that every soldier in the Continental Army had to be inoculated against smallpox

Edward Jenner conducts experiments in 1796 that led to the creation of the first smallpox vaccine a few years later and replaces variolation as a preventative for smallpox

*Dr. Luigi Sacco becomes the Jenner of Italy

James Madison, one of the Founding Fathers, signed the Vaccine Act of 1813 – An Act to encourage Vaccination.

a vaccine for rabies is developed by Louis Pasteur in 1885

vaccines for cholera and typhoid were developed in 1896 and a plague vaccine in 1887

the first diphtheria vaccine is developed in about 1913 through the work of Emil Adolf Behring, William Hallock Park, and others

the first whole-cell pertussis vaccines is developed in 1914, although it will take several decades before they are more widely used

a tetanus vaccine is developed in 1927

12 children die when a multi-use bottle of diphtheria vaccine that didn’t contain a preservative became contaminated with bacteria in the Queensland Disaster in 1928

Max Theiler develops the first yellow fever vaccine in 1936

the AAP formally approves the use of a pertussis vaccine created by Pearl Kendrick and Grace Eldering in 1943

the first flu vaccine is licensed for use in the US in 1945

End of the Pre-Vaccine Era

In the mid-20th century, we started to get vaccines to control diseases that many of us have never seen, like polio, measles, and rubella.

the individual diphtheria, tetanus, and pertussis vaccines become combined in a single DTP vaccine in 1948

the last smallpox outbreak in the United States kills one person, Lillian Barber, in the Rio Grande Valley of South Texas in 1949

the Salk inactivated polio vaccine (IPV) is introduced in 1955

President Dwight D Eisenhower signed the Polio Vaccination Assistance Act in 1955, which gave $30 million in federal grants to states to cover the costs of planning and conducting polio vaccination programs, including purchasing polio vaccine

about 200 children develop polio in 1955 from contaminated polio vaccines in what becomes known as the Cutter Incident

President John F Kennedy signed the Vaccination Assistance Act in 1962 (Section 317 of the Public Health Service Act), which started as a three year program to help get kids vaccinated against polio, diphtheria, tetanus, and pertussis, but it has been continuously reauthorized ever since

the first live measles vaccine was licensed in 1963 but was replaced with a further attenuated measles virus that caused fewer side effects in 1968

President Lyndon B Johnson established a legacy of US leadership in global immunization by funding the CDC Smallpox Eradication program in 1965

the MMR vaccine becomes available in 1971, combined the vaccines for measles, mumps (licensed in 1967), and rubella (1969), and was routinely given when toddlers were about 15 months old

routine vaccination with smallpox vaccines end in the US in 1972

The Vaccination Era

The end of the 20th century brought more vaccines and protection against even more now vaccine preventable diseases.

Pneumovax, the first pneumococcal vaccine that protects kids and adults from certain types of Streptococcus pneumoniae bacteria is approved in 1971 and is given to high-risk kids

President Jimmy Carter’s National Childhood Immunization Initiative in 1977 reached its goal of immunizing 90% of children

the Thirty-Third World Health Assembly declares that smallpox is eradicated in 1979

Menomune, the first meningococcal vaccine is licensed in 1981 and is recommended for high-risk kids until it is later replaced by Menactra

a Haemophilus b capsular polysaccharide vaccine is licensed in 1985, but unfortunately does not provide good protection in kids younger than 18 to 24 months, who are most at risk for Haemophilus influenzae Type b disease

a recombinant hepatitis B vaccine (Recombivax HB) is approved in 1986 but is only recommended to be used in those at high risk for infection

another hepatitis B vaccine, Engerix-B, is approved in 1989

the first Haemophilus b conjugate vaccine (PRP-D) is approved in 1988 to provide protection against Haemophilus influenzae type b disease in all kids at least 18 months old, but in 1990, they are replaced with two improved Hib conjugate vaccines (PRP-HbOC and PRP-OMP) that can be given to infants as young as two months old

a booster dose of MMR is first recommended in 1989, but only for kids who live in counties that have at least 5 cases of measles. The routine 2 dose MMR schedule wasn’t put into use for all kids until 1994.

the Vaccine Adverse Events Reporting System (VAERS) is established in 1990

the hepatitis B and Hib vaccines are recommended for all infants in 1991

after year’s of neglect under President Reagan, President George HW Bush’s immunization action plan in 1991 once again raised immunization rates following three years of measles outbreaks

the DTaP vaccine, which is supposed to have fewer side effects than DTP is licensed, and by 1997 replaces DTP for all required doses, although DTP is never actually shown to have caused seizures or brain damage, as was once claimed in Vaccine Roulette

President Bill Clinton’s Childhood Immunization Initiative in 1993 includes signing the Vaccines for Children (VFC) Act, providing free vaccines to many children

the WHO declares that polio has been eliminated from the Western Hemisphere in 1994

a vaccine to protect kids against chicken pox (Varivax) is licensed in 1995

VAQTA, the first hepatitis A vaccine is approved by the FDA in 1996 for kids who are at least two years old, but is mainly given to kids at high risk to get hepatitis A

the Salk inactivated polio vaccine (IPV) is once again recommended for kids and replaces the oral polio vaccine (OPV) in 1996 because of a small risk of vaccine-associated paralytic poliomyelitis (VAPP), beginning with a sequential IPV-OPV vaccine schedule and then going to an all IPV schedule in 2000

RotaShield, the first rotavirus vaccine is licensed in 1998 but is soon withdrawn from the market in 1999 after it is associated with an increased risk of intussusception, a form of bowel obstruction

LYMErix, a Lyme disease vaccine, is licensed in 1998

Dr. Andrew Wakefield publishes a report in the journal Lancet and attempts to link the MMR vaccine to autism

thimerosal is removed from the vast majority of vaccines in the childhood immunization schedule in 1999 and 2000

endemic measles is declared eliminated in the United States in 2000

Prevnar, a newer pneumococcal vaccine is licensed in 2000 and is added to the immunization schedule the next year

LYMErix goes off the market because of insufficient sales in 2002

Flumist, a live, intranasal flu vaccine, is approved in 2004

endemic rubella is declared eliminated in the United States in 2004

a flu shot for all healthy children between 6 and 23 months became a formal recommendation for the 2004-05 flu season.

beginning in the 2004-05 flu season, a flu shot is recommended for women who will be pregnant during flu season, in any trimester, which is different than previous recommendations for a flu vaccine if a women was going to be beyond the first trimester of pregnancy during flu season. Unfortunately, even though they are in a high-risk category, only about only 13% of pregnant women received a flu vaccine in 2003.

Havrix, another hepatitis A vaccine, is approved in 2005 and the age indication for both hepatitis A vaccines is lowered to 12 months.

Menactra, a vaccine to protect against certain types of meningococcal disease is licensed in 2005 and is added to the immunization schedule in 2006, being recommended for all at 11 to 12 years of age or when they enter high school

the Tdap vaccine (Boostrix or Adacel) is recommended for teens and adults to protect them from pertussis in 2006 and replaces the previous Td vaccine that only worked against tetanus and diphtheria

RotaTeq, another rotavirus vaccine, is licensed in 2006, and is added to the immunization schedule in 2007

the hepatitis A vaccine is added to the routine childhood immunization schedule in 2006

a 2nd booster dose of the chicken pox vaccine is added to the immunization schedule in 2007 to help prevent breakthrough infections

The Post Vaccination Era

Why call it the post-vaccination era?

It has been some time since a vaccine for a new disease has been added to the routine vaccination schedule, but we are also starting to see more and more outbreaks of old diseases, especially pertussis, mumps, and measles.

another rotavirus vaccine, RotaRix, is approved in 2008

another HPV vaccine, Cervarix, is approved in 2009

another meningococcal vaccine, Menveo, is approved in 2010

a newer version of Prevnar, which can provide coverage against 13 strains of the pneumococcal bacteria, is approved and replaces the older version (Prevnar 7) in 2010

Fluzone Intradermal and Fluzone High-Dose are two new flu vaccine options that became available in 2011

a combination vaccine that protects against both Haemophilus influenzae type b and Neisseria meningitidis serogroups C and Y was approved by the FDA in 2013. MenHibrix is recommended for infants at high risk for meningococcal disease.

Quadrivalent flu vaccines, which protect against four strains of flu, become available for the 2013-14 flu season

Trumenba, the first vaccine to protect against serogroup B Meningococcal disease is approved by the FDA (October 2014). Previously, Bexsero, a MenB vaccine that is approved in some other countries, was given to some college students during outbreaks under the FDA’s expanded access program for investigational products. Both are now recommended by the ACIP for those at increased risk for meningococcal serogroup B infections.

Gardasil 9 is approved by the FDA (December 2014) to provide protection against five additional types of HPV.